County responds to inpatient psychiatric facility’s impending closure

REGION — The chairwoman of the County Board of Supervisors is calling for an Oct. 30 conference to address the potential closure of inpatient psychiatric units across the county due to a recent change in federal guidelines.

Tri-City Healthcare District in June voted to shutter the region’s only inpatient mental health facility, which includes an 18-bed behavioral health unit and a 12-person crisis stabilization unit, in 60 days. The closure could displace nearly 100 workers and force residents with psychiatric emergencies out of the region for treatment.

Tri-City officials cited a recent change in federal regulations requiring hospitals to remove from rooms all features that patients could use to hang themselves, known as “ligature” risks, as the primary reason for the closure. They also cited a $5 million budget shortfall within the department that oversees the unit, as well as a shortage of psychiatrists to staff the unit.

“We’ve been open to solutions, but none of the solutions have addressed the issues in a comprehensive and sustainable way,” Aaron Byzak, Tri-City government and external affairs director, said. “What we have is unsustainable.”

Tri-City’s board chair in June said that all of the rooms in the hospital’s behavioral health unit had “drop” ceilings, which hide various structures that the government would consider ligature risks. Board members said the unit would have to be shut down for at least one year in order to retrofit the unit.

Other area hospitals which have inpatient beds are also grappling with the new regulations, but none have said they would require closure.

The County Board of Supervisors addressed the closure at the July 24 meeting, and Chairwoman Kristin Gaspar called for the board to host a conference in October to discuss “innovative ideas to work together on this issue.”

“Now more than ever, we need to come together as a region to collaborate for regional solutions. We must be bold and innovative as we explore sustainable options,” Gaspar said in a statement. “It is vital that we take a comprehensive and inclusive approach and look at opportunities to collectively strengthen and expand our entire continuum of care. Inpatient psychiatric care is only one part of that continuum. If any part of the continuum is not sustainable, the entire system will begin to fail.

“If we address this now, and we address this collaboratively, we can reduce the impacts to the patients, to the community and to the taxpayer,” Gaspar said.

Byzak said that Gaspar’s statement echoes the hospital’s concerns about the continuum of care, of which inpatient services is a small portion. The hospital, he said, will spearhead legislative reform to address the issues with the retrofit regulations and other issues that he said are making operating psychiatric care fiscally unsustainable.

But in the short term, despite concerns expressed by elected officials and the mental health community, the hospital will proceed with the suspension.

“We have to operate a hospital within the guidelines of CMS (Center for Medicare and Medicaid Services), we have to operate a safe hospital, so anything short of that is not an option,” Byzak said.